Sergio Enrique Lopez, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

27129 Issued in TX

Practice address

1507 S McColl Rd
Edinburg, TX 78541-4265

Phone

(956) 720-4345

Fax

(956) 720-4329

NPI assigned

Jul 12, 2011

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sergio E Lopez, DDS, Pediatric Dentistry, PLLC

  • Pediatric Dentistry
  • Edinburg, TX
  • NPI 1104207653
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1154619088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 BOB BULLOCK LOOP",
            "address_2": "APT. 8101",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780434265",
            "telephone_number": "956-212-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 S MCCOLL RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785414265",
            "telephone_number": "956-720-4345",
            "fax_number": "956-720-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "SERGIO",
        "middle_name": "ENRIQUE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-12",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "27129",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "27129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295598107",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Meador Lopez, CRNA
• Luis Ali Lopez
• Maria Elena Lopez, LMSW
• Martha Lydia Lopez, LPC
• Noemi Lopez, NP
• Stephen Samuel Lopez
• Valeria Lopez
• Valerie Evonne Lopez, MD
• Victor Hugo Lopez, MD
• Carmina Loredo

• Pediatric Dentistry in Edinburg, TX
• Providers in Edinburg, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.